Social Care

Baroness Keeley Excerpts

Wednesday 25th October 2017 Commons Chamber

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I beg to move,

That this House notes the Conservative Party’s manifesto commitment to a funding proposal for social care which would have no cap on care costs and would include the value of homes in the means test for care at home; further notes that this proposal would leave people with a maximum of only £100,000 of assets; calls on the Government to confirm its intention not to proceed with this commitment; and further calls on the Government to remove the threat to withdraw social care funding from, and stop fines on, local authorities for Delayed Transfers of Care and to commit to the extra funding needed to close the social care funding gap for 2017 and the remaining years of the 2017 Parliament.

After the debacle of the dementia tax, there has been continuing concern that the current and future issues about the funding of social care are not being addressed. The worries stirred up by the Conservative party during the general election will not be resolved without a better idea about what the future now holds for social care.

One place where people were expecting to hear some discussion on this was at the party conferences in September, but if we thought that we would hear about it in the conference speeches of the Secretaries of State responsible for social care, we were sadly let down.

At the Labour party conference, I talked about the crisis in social care and how it was failing those who need care and their families, failing unpaid family carers and failing hundreds of thousands of care workers. People needing care and their carers face the greatest impact. Since the Conservatives came to power in 2010, there are 400,000 fewer people receiving publicly funded care and, sadly, more than 1.2 million people now living with unmet care needs, many of whom are isolated and lonely.

[Kelvin Hopkins (Luton North) (Lab)]

My hon. Friend is raising a very important issue, which is leading to a lot of suffering among elderly people in particular. Will she make reference to the Royal Commission on Long Term Care for the Elderly, which, almost two decades ago, recommended free long-term care for all? That is where we should be.

[Barbara Keeley]

I will talk about how the Labour party will take forward proposals on the future of social care. We wait to hear what the Government choose to do. My hon. Friend is right that there is a driving need now.

The number of people—1.2 million—living with unmet care needs will inevitably rise without an injection of new funding. A lack of publicly funded care means that the task of meeting care needs falls more heavily on unpaid family carers. Many carers have to give up work because of the demands of caring, which has a real impact on their finances and future career prospects. The case for listening to carers and giving them more support is overwhelming. We were expecting a new carers’ strategy this spring, or, at the latest, in the summer. Some 6,500 carers had taken the time over and above their caring responsibilities to respond to the Government’s consultation. However, the Care Minister told me that the responses will merely be taken forward into a new consultation on social care.

Katy Styles, a carer and a campaigner for the Motor Neurone Disease Association, contributed to that consultation and hoped that her voice would be heard, alongside 6,500 other carers. She told me:

“Not publishing the National Carers Strategy has made me extremely angry. It sends a message that carers’ lives are unimportant. It sends a message that Government thinks we can carry on as we are. It sends a message that my own time is of little worth.”

That is a shabby way to treat carers—the people who provide more than 50% of the care in this country.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The hon. Lady refers to unpaid carers. Labour’s motion references the Communities and Local Government Committee report on adult social care, which looked at the German system of social insurance. Under that system, payments are made to family members to remunerate them for that care. Has she read that report, and is it something that she is willing to look at in further detail on a cross-party basis?

[Barbara Keeley]

I will come on later to discuss how we should proceed and whether we should proceed on a cross-party basis. The hon. Gentleman’s point about carers and family carers is important. The plain fact of the matter is that there was nothing for carers in his party’s manifesto. We had announced that we were going to lift carer’s allowance at least to the level of jobseeker’s allowance. That is the only improvement that was discussed during the general election. He should turn to his own Minister and his own party and ask them what they will do for carers.

[Mr Mark Harper (Forest of Dean) (Con)]

I welcome the hon. Lady’s tone in this debate. It is very valuable. I know that she has taken an enormous interest in this subject, even when it has not fallen within her Front-Bench responsibilities. These debates are very helpful in educating people about difficult issues. I am happy to accept that we did not handle this issue well in the general election. The mistake that we made was not being clear about the current system, which is why her reference in the motion to our proposal without setting out the current system in which people can potentially lose all but £23,000 of their assets is disappointing. Such information would have helped to contribute to the public debate.

[Barbara Keeley]

We will come on to that. If the right hon. Gentleman wants to get into the mess that his party made, the truth is that we legislated a number of years ago to lift the asset floor to £118,000. What his party did during the election was drop that to £100,000. At the weekend, we learned that there was an intention to make it only £50,000. He should be clear about what his Front-Bench colleagues were trying to do. Since then, all we have heard is a deafening silence.

We need to focus on the crisis in social care now. We on the Labour Benches have raised many times just how fragile the care sector is after years of swingeing budget cuts by the Government. A survey by the Association of Directors of Adult Social Services reported that more than two thirds of councils had reported closures of care providers in the first five months of the financial year. Nearly half those councils had had homecare providers handing back contracts.

[Kelvin Hopkins]

My hon. Friend refers again to local authority care homes. In my constituency, three superb local authority care homes were forcibly closed effectively by Government policy. They were loved by the residents. They had full-time, permanently employed trade union staff and were supported and applauded by the local healthcare professionals. They were all closed. Now we have only the private sector, which is in crisis.

[Barbara Keeley]

It is very important that we bear in mind that the 1.45 million workforce in care will have been local government employees and will have enjoyed local government terms and conditions. We have talked many times about the fact that they are not now paid the minimum wage or travel time. They are very badly paid, with no pensions in prospect.

[Kate Green (Stretford and Urmston) (Lab)]

As my hon. Friend knows, in my constituency, which neighbours hers, we have a real problem in recruiting and retaining care workers, many of whom tell me that they can get better paid work in the local Asda than by doing the job that they love. Does she not agree that that is in part due to the fact that private providers, who would like to pay their staff more, cannot do so because of the insufficiency of the value of the contracts that they receive from the local authority?

[Barbara Keeley]

That is absolutely the case. In fact, in a recent meeting with Unison, I was told that, in our area in Greater Manchester, one person could be paid more for putting toppings on to pizzas at Morrisons than for providing care—often to people with dementia or to those who really need that help.

[Huw Merriman (Bexhill and Battle) (Con)]

The hon. Lady talks about a squeeze in funding. On that basis, does she agree that it would be right to ask those who do have the means to contribute more towards their social care in the home?

[Barbara Keeley]

No, I do not agree with the hon. Gentleman. That is one of the reasons why his party’s dementia tax policy failed so badly. Suddenly to bring hundreds of thousands of people into means-testing using their homes was one of the biggest flaws in the policy that the Conservative party floated.

I will now make a little bit of progress on the state of care, because the fragility of the care sector is a key issue. We heard from my hon. Friend the Member for Luton North (Kelvin Hopkins) about closures in his area, but councils cannot even influence these closures much any more because home care providers are handing back contracts. Indeed, one in five councils in the ADASS survey reported closures in all three services: home care, residential care and nursing home services. There are also serious issues of care quality in many areas of the country.

The survey reported that 70% of the councils surveyed had experienced quality issues across all three types of care services. ADASS estimates that 28,000 people have been affected by care-quality issues or by a change of service due to contracts being handed back. We know that it is a big issue for a person with dementia to have a continual change in the care staff visiting them. Those arguing in favour of cuts need to think about those 28,000 lives affected negatively by cuts to local authority budgets. Worryingly, the Care Quality Commission now reports that almost a quarter of care services are not meeting standards on safety, and nearly a fifth of services require improvement overall.

I said earlier that budget cuts mean that more than 400,000 fewer people are now getting publicly funded care. Of course, councillors, council leaders and social workers have had to make difficult decisions about cutting budgets and cutting support to local people. It is of great credit to councils and council leaders that so many still continue to prioritise adult social care in their budget setting, but the overall position is one of cuts. There will be a real-terms loss of £6.3 billion to adult social care by the end of this financial year, and we heard earlier from my hon. Friend the Member for Manchester, Gorton (Afzal Khan) about the level of cuts in the city of Manchester. The cuts have an impact on staff working in social care.

[Jack Dromey (Birmingham, Erdington) (Lab)]

At last, the Government and Her Majesty’s Revenue and Customs have acknowledged that care workers who sleep in, giving loving care to those badly in need of care, are entitled to the national minimum wage. But, as a consequence, a crisis confronts the sector. Mencap says that it is the

“final nail in the coffin for many providers”,

with jobs lost and the risk of bankruptcy for a number of people with personal care packages. Does my hon. Friend agree that the Government who created this problem should solve this problem and not expect local authorities to pick up the bill?

[Barbara Keeley]

I absolutely agree, and it was helpful of my hon. Friend to make that point. The sleep-ins issue has been a real cause of worry for many organisations over many months. It just goes to the heart of our assertion that people who work in care should be paid the minimum wage, including when they are working at night, which is what they are doing on sleep-ins. I have a constituent who looks after two households of people in adjoining properties, and she does not get normal sleep during the night as alarms can go off in any part of the properties. It is not right at all that those people were paid just fixed amounts, not the minimum wage. The Government must find the funding for that decision.

[Kelvin Hopkins]

I do apologise for intervening so often. Does my hon. Friend agree, as my hon. Friend the Member for Birmingham, Erdington (Jack Dromey) has hinted, that the whole care sector ought to be in the public sector in the longer term at least, provided on the same basis—free at the point of need—as the national health service?

[Barbara Keeley]

As I said earlier, I will come to our proposals; I do not want to jump around in my speech too much more.

Going back to staff working in social care, it is important to remember and think about social workers, not just care staff. A recent study found that less than half the social workers surveyed felt that decisions about a person’s care and support were being left to their professional judgment; it is now all about budgets. More than a third said that they had felt unable to get people the care they need. Less than half felt supported to have necessary difficult conversations about changes to care with people needing care and their families.

The social care crisis is a direct result of the cuts that this Government have chosen to make. The King’s Fund, the Health Foundation and the Nuffield Trust estimated that there would be a funding gap in social care budgets of £1.9 billion for this year, but the extra funding in the Budget was only £1 billion, so there is still a funding gap of £900 million this year. Labour pledged an extra £1 billion for social care this year to start to deal with that funding crisis. However, the Government have chosen instead to put the pressure on local authorities and hard-pressed local council taxpayers to deal with that social crisis, which was made in Downing Street.

Delayed transfers of care due to social care cuts increased by more than a quarter in the 12 months to August this year, putting extra pressure on local councils. Now, sadly, Ministers are threatening councils with fines and further funding cuts to social care if targets for cutting delayed transfers of care cannot be met. Indeed, ADASS reported that half the social services directors it surveyed believe that their targets for delayed transfers were unrealistic. It is barely believable that the Government’s response to the social care crisis is to threaten to make the situation worse by cutting funding for social care even further. Some councils experiencing problems meeting targets were even summoned by NHS leaders last week to a meeting to review their performance challenges.

Many people have said that the approach of blaming and penalising local councils is not sustainable. The Conservative chair of the Local Government Association, Lord Porter, said of the warning letters sent from Ministers to councils:

“No council wants to see anyone stay in hospital for a day longer than necessary. These letters are hugely unhelpful at a time when local government and the NHS need to work together to tackle the health and social care crisis.”

The president of the ADASS, Margaret Willcox, has described the Government’s actions in threatening councils with further sanctions as, “frankly bizarre”. David Oliver, who is clinical vice-president of the Royal College of Physicians and a geriatric consultant, said about delayed transfers of care:

“Some of these delays are due to systematic cuts to social care budgets and provision. Others are due to a serious lack of capacity in community healthcare services…attempts to solve the problem through initiatives like the Better Care Fund or pressure from NHS England have failed”.

Interestingly, Andrea Sutcliffe, the chief inspector of social care at the Care Quality Commission, said:

“I worry that if people focus just on moving people through the system quickly then does that mean that they will force the discharge of somebody that is old and frail into a service which we have rated ‘inadequate’”.

We now have a Government who are driving the NHS to be obsessed with dealing with delayed transfers of care, seemingly above all else. This obsession causes further problems if patients are discharged without planning what they need outside hospital.

Age UK give an example that was brought to it:

“Terry’s father Richard, 85, is in hospital following a stroke. He is ready for discharge and has been assessed as needing rehabilitative care through two home visits a day. However he was then told that there are no reablement services available in his area. Terry has been told to ‘get his father out of hospital’ and to look for and fund the care himself.”

My own local hospital, Salford Royal, sadly seems to have similar issues. Last week, I spoke to a constituent who described her own discharge by saying, “I was thrown out of hospital.” Having had surgery for an infected bite that caused sepsis and a hand that she could not use, my constituent was given no discharge summary, no advice on how to manage her wound and no advice about her recovery. When she struggled to get dressed, she was told that she had to get out quickly, otherwise, “This will count as a failed discharge.” This a theme we may remember from last winter.

I remind the Minister that the British Red Cross talked then of a humanitarian crisis whereby people were sent home without clothes or into chaotic situations. Those chaotic situations involved them falling and not being found for hours, or not being washed because there were no care staff to help them. Ordering patients out of hospital when there is no reablement service for them, without advice about wounds or recovery, or to a care facility rated as inadequate just to meet unrealistic targets on delayed discharge is a recipe for an even worse crisis this winter.

[Huw Merriman]

The social care and hospital budgets have been merged in East Sussex, where my constituency is. As a result, the A&E is now the fastest-improved A&E department in the whole of England. That change is working. Would the hon. Lady’s local authority consider the same model?

[Barbara Keeley]

My local authority has the most advanced example of an integrated care organisation in the country—we have already transferred all our social care staff to work for Salford Royal. I have just quoted a situation that shows how the pressure being put on hospitals because of delayed transfers of care is causing them to treat people such as my constituent in the way I described. Conservative Members ought to listen to that, because it is their Government and their Ministers who are causing this pressure to be put on hospitals.

We know that demand on social care is increasing as more people live longer with more complex conditions. The number of people aged 75 and over is projected nearly to double by 2039. That ought to be something to celebrate, but instead the Government have created fear and uncertainty for older people by failing to address the health and care challenges raised by those demographic changes. Indeed, the Conservative party is spending less money on social care now than Labour was when it left office in 2010. The Government seem to have no plan to develop a sustainable solution to the funding of social care in the longer term; they have talked only of a consultation followed by a Green Paper.

Furthermore—and this is raising real fears—the focus has been entirely on the needs of older people, without consideration being given to the needs of the 280,000 working-age people with disabilities or learning disabilities in the social care system. That is profoundly short-sighted, because the financial pressures on local authorities due to the increasing care needs of younger adults with disabilities or mental health problems are now greater than those due to the need to support older people.

[Kate Green]

I am glad my hon. Friend has mentioned younger adults. Does she agree that investing in the care they need will facilitate the Government’s achievement of their ambition to have more disabled people who can work in paid employment? Relatively low levels of expenditure on care for those people would pay great dividends for the Government and the country.

[Barbara Keeley]

Very much so. I thank my hon. Friend for making that point. It is concerning that planned consultations or discussions about future policy should focus so much on older people, when the needs of people with disabilities and learning disabilities are so important. We talked about learning disabilities in a debate last week.

Labour will fill the policy vacuum that exists around social care under this Government. Over the coming months, we will consult experts on how we can move from the current broken system of care to a sustainable service for the long term. We will look at funding options for social care in the long term, such as wealth taxes, an employer care contribution or a new social care levy. Those experts will help clarify the options for funding our planned national care service. Our approach will be underpinned by the principle of pooled risk, so that no one faces catastrophic care costs as they do now or as they would under the Conservative party’s dementia tax.

Our plans are for a national care service. They are based on a consultation—the “Big Care Debate”—that involved 68,000 people. People in that consultation told us that they needed a system that will support them and their families to live the lives they want, that will treat everyone with dignity and respect and that will give them choice and control over their care. I believe those needs remain the same, and they will be at the heart of our ambition for social care.

I urge hon. Members from all parties to vote with the Opposition today so that we can set the foundations for a safer, more sustainable and higher quality care system for the future and reassure those who have become worried about the Conservative party’s dementia tax mess.

[Craig Mackinlay (South Thanet) (Con)]

I am always very impressed by the hon. Lady’s knowledge in this area, but just to clarify, did I hear her say that she was considering wealth taxes as a means to pay for these proposals? She talked about a policy vacuum, but I would be interested to hear how the money vacuum would be filled. I am also somewhat concerned—I hope she will explain this—that a national care system rather puts families aside.

[Barbara Keeley]

I am obviously coming to the end of my speech, but I recommend that the hon. Gentleman, if he is interested, read a number of documents. The Labour Government produced a White Paper for a national care service; it is still available, and I advise him to look at it. Given everything I have said about carers in this speech, there is no way that we would not include them as an important part of our proposals, but the burden should not just be dumped on them. Carers should be partners in care, and they should be supported so that they have a life of their own. It is said that the only numbers put on the Conservative party’s proposals for a dementia tax in its manifesto were the page numbers. The Labour party has produced the document I have here—“Funding Britain’s Future”—and a fully costed manifesto. If the hon. Gentleman has a bit more time for reading, I advise him to go to our manifesto and to look at how we laid out the options. We laid them out; we did not get into a mess, as the Conservative party did, and try to change things after four days. We will take this issue forward; we will not kick it into the long grass, as the Conservative party is trying to do.

[Rachel Maclean (Redditch) (Con)]

Will the hon. Lady give way?

[Barbara Keeley]

No, I am just going to finish.

Our motion asks for action to make sure the care sector gets the urgent funding it needs to prevent collapse. It would also ensure that hard-pressed councils are not penalised for failing to meet unrealistic targets for delayed transfers of care.

--- Later in debate ---

[Jackie Doyle-Price]

I could not agree more. I share my right hon. Friend’s support for the hon. Lady’s comments. There are still many opportunities to get working-age adults with disabilities into work. We have set ourselves a target of getting 1 million more people with disabilities into work, and we are very committed to doing that.

In response to the point made by the hon. Member for Worsley and Eccles South in her opening remarks, yes, much of the debate has focused on how we care for the elderly, but, as she and the whole House will be aware, support for working-age adults is becoming an increasingly big proportion of local authority spending in this area, and it is very important that we focus on it. Alongside the preparations we are making for consultation in the new year, we have a parallel work stream looking specifically at working-age adults, because some of the solutions will be similar and some will be different.

[Barbara Keeley]

It is very important that we have got to this point today, because very many organisations and individuals have been worried for months about that. In the Queen’s Speech and in letters the Minister has sent to me, the talk has been of a consultation on social care for older people. The wording needs to change if that is to encompass, as it should, working-age people with disabilities or learning disabilities. Let us stop focusing just on older people. If she would stop doing that in letters and we could have clarity on this, it would be helpful. I also wonder why there has to be a separate work stream.

[Jackie Doyle-Price]

There needs to be a separate work stream because it is connected to the desire to get more people into work, but the two programmes are working in parallel. As I said, today is a great opportunity to get that on the record. Certainly, it has been very much a focus of my conversations with voluntary groups in the sector.

--- Later in debate ---

[Jackie Doyle-Price]

I must make some progress, because I have taken many interventions. I do apologise.

Adult social care funding is made up of Government grant, council tax and business rates. The better care fund, which was announced in 2013, has further helped to join up health and care services so that people can manage their own health and wellbeing and live independently in their communities for as long as possible. The 2015 spending review introduced an adult social care precept that enabled councils to raise council tax specifically to support social care services. By 2019-20, that could raise up to £1.8 billion extra for councils each year. As a further boost to social care, the Chancellor announced in the Budget earlier this year that local authorities in England will receive an additional £2 billion for social care over the next three years. This year, £1 billion has been provided to ensure that councils can fund more care packages immediately. The additional money means that local authorities in England will receive an estimated increase of £9.25 billion in the dedicated money available for social care over the next three years. Statistics produced today show that spending on adult social care increased in real terms last year by 1.5% thanks, in part, to the precept.

[Barbara Keeley]

This is an important point. Our motion mentions the need to close the funding gap, which is not £1 billion but £1.9 billion. So £900 million is still not covered, and that is what councils are struggling with. The Minister makes the point about extra funding being raised from local taxation. Does she accept that there is still a funding gap, which means that people cannot be paid the national living wage? We are going to struggle all the way through winter unless the Government accept the existence of that gap and work to close it.

[Jackie Doyle-Price]

I do not accept that. Let us recognise that this has been hard in the past. We have made money available in recent years, but we know that local authorities have faced challenges. As one local authority put it to me, however, austerity has been the mother of invention, and I congratulate local authorities on the efforts that they have made. [Interruption.] That came from a local authority leader, and I agree that local authorities have shown considerable initiative by implementing savings. As for the national minimum wage, it is enforceable, so I do not accept the hon. Lady’s point at all.

[Barbara Keeley]

Does the Minister accept that the Government are providing less funding for social care than they were in 2010? She can check that with NHS Digital. The funding is less in real terms. It does not matter that it has increased this year because of the social care levy; it is less. Given the complexity of the issue and the growing demographic challenge, it is clear why we have this gap.

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[Jackie Doyle-Price]

I reject the suggestion that there will be any kind of fine. The £22 million that the hon. Lady talks about will be retained for spending within Leicestershire. That funding has been allocated for a specific purpose, and where local authorities are not showing the improvement that we expect, we will work collaboratively with them and advise them how best to use that money.

Let me put on record exactly what we are going to do. There is significant variation in performance across local areas. We know that 41 health and wellbeing boards are collectively responsible for 56.4% of adult social care delayed transfers of care. That cannot be right, when other local authority areas have none. In particular, Newcastle has no adult social care delayed transfers of care, and if it can do that, other areas can as well, provided we have good partnerships and good leadership. I trust that I have demonstrated the extent to which the Government are supportive of the best performing systems where local government and the NHS are working together to tackle this challenge. However, we are clear that we must make much faster and more significant progress in advance of winter to help to free up hospital beds for the sickest patients and to reduce pressures on our A&E departments.

It is right that there should be consequences for those who fail to improve. Earlier this month, we wrote to all local authority areas informing them that if their performance did not improve, the Government may direct the spending of the poorest performers—it is not a fine—and we reserve the right to review allocations. It is important to note that the allocations will remain with local government to be spent on adult social care. It is not a fine; this is about making sure that public money delivers the intended outcomes.

[Barbara Keeley]

Is the Minister saying that revising an allocation is not a fine? When an allocation is revised—presumably downwards, not upwards—that is a fine.

[Jackie Doyle-Price]

I am sorry, but that is not the case. The money will be retained by local government, but we will direct the spending to achieve the outcome the money is intended to deliver. That is exactly what we should do as a Government, and it is how we ensure value for money.

The health and care system has committed staff and managers up and down the country who are working every single day to deliver the best outcomes for people.

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[Helen Whately (Faversham and Mid Kent) (Con)]

I am sure that all of us who have been out and about with care workers in our constituencies have found the experience not only informative but inspiring. I certainly had a brilliant experience when I went out and about with a care worker in my patch. I saw the enormous compassion in the care that she provided and how incredibly hard she worked. It was a tough job, but a rewarding one. As many Members have said, however, the work is not well enough paid, there is no career structure and there is not enough support for carers in their day-to-day work.

Everyone in the Chamber today recognises that the current system is not fair and not working. It is not fair that people can get care for free if they can stay living in their home, but if they have to go into a care home, they might be left with only £14,000 of savings. Most people would much rather be cared for at home, but that is not always possible. The present system therefore discriminates against those who cannot stay at home to be cared for, and that is simply not fair. We need to bear that in mind as we talk about potential solutions. Let us not pretend for a moment that the current system is fair.

The system is also not working. Around 30% of the people in hospital in my constituency do not need to be there. They would be better off out of hospital, but there is often no outside support available for them. Delayed transfers of care are an ongoing challenge. There are also people in care homes because of the shortage of domiciliary care. We have to address what is substantially a funding challenge: there is simply not enough money going into care.

The shadow Minister, the hon. Member for Worsley and Eccles South (Barbara Keeley), said that she was going to give us Labour’s solutions to the problem. I listened carefully to her speech, but I was disappointed that she spent only about one minute of her 24-minute speech talking about potential solutions. I am afraid that I did not really hear any solutions—

[Barbara Keeley]

Will the hon. Lady give way?

[Helen Whately]

I am really sorry, but I cannot take any interventions. I have been asked not to.

Most significantly, the hon. Lady does not have a plan for how to pay for all this. It all comes down to how we are going to pay for improving access to care, and the Labour party simply does not have a plan. As for cross-party working, that would be fantastic but judging by some of the language I have heard from Labour Members, I do not think that many of them are ready to work together on this. I encourage the Government to get on with the job of proposing a better, sustainably funded, care system so that our constituents can get the care that they need.

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[The Parliamentary Under-Secretary of State for Communities and Local Government (Mr Marcus Jones)]

This has been a wide-ranging and important debate on one of the most important social issues and challenges we face in our country.

Delivering good-quality care for our most vulnerable people is a clear priority for this Government. To ensure local government has the resources to fund adult social care through to 2019-20, the Government have given councils access to £9.25 billion of dedicated funding for adult social care over the next three years.

Beyond the immediate term, there is also the need to address the challenges of social care for our ageing population. Therefore, the Government will bring forward proposals for consultation, to build widespread support for reform. The consultation will set out options to improve the social care system, put it on a more secure financial footing, support people and their families to prepare for old age, and address issues related to the quality of care and the variation in practice.

Overall, local government spent £14.9 billion in 2016-17 on adult social care—up by £500 million from 2015-16, and over £500 million more than budgeted for. This year, councils are budgeted to spend £15.6 billion.

The Government continue to provide local government with the additional resource it needs to deliver care. At the spring Budget, an additional £2 billion of funding in England was announced, of which £1 billion has been provided in 2017-18. That was in addition to the resource made available in the local government finance settlement, where we provided £240 million for adult social care. It was also in addition to the £2.5 billion put through local authorities in the improved better care fund.

Alongside Government funding, more flexibility has been provided. Local government has been able to raise more income through the adult social care precept, with the flexibility to increase it by 3% this year. That adult social care flexibility was subsequently used by 147 out of 152 social care authorities, with 109 using the full allocation, or close to the full allocation, of 3%. I should point out that it is also down to the Government that, overall, council tax remains lower in real terms than it was in 2010.

In terms of the integration of health and social care, we should remember that the better care fund is the first national mandatory integration policy. We should not shy away from the fact that integration is not easy, but the Government are supportive of the best-performing systems, where local government and the NHS work together to tackle the difficult issue of delayed transfers of care. We understand that delayed transfers of care are only one part of what authorities deal with to deliver social care in communities up and down the country, but we also understand that improving working between local government and the NHS is absolutely key to delivering better joined-up care for local people.

It is also right that, in November, we will consider a review of the 2018-19 allocations of social care funding provided at the spring Budget 2017 for areas that are not performing well. We expect that that would encompass only a small number of local authorities, although we are clear that the funding will remain with local government to be used for adult social care. We also favour, if needed, the option that places conditions on how a proportion of the 2018-19 funding is used to support an authority’s delayed transfer of care performance.

[Barbara Keeley]

Will the Minister give way?

[Mr Jones]

I will in a moment, but I want to make a little more progress and mention some of the people who have spoken in the debate.

The hon. Member for Denton and Reddish (Andrew Gwynne) finally hit the nail on the head right at the end of his speech in saying that we needed to approach this important, difficult and delicate subject in a non-partisan way. I was very disappointed, though, that 98% of his speech was spent on the politics of fear and, in some ways, misinformation. That was very much out of kilter with much of the debate across the House.

My hon. Friend the Member for Totnes (Dr Wollaston), the Chair of the Health Committee, made some very important points. She was absolutely right first to pay tribute to careworkers and carers—that is absolutely the right thing for us to do. She mentioned the remuneration of care work, as did other hon. Members across the House. It is important to point out that careworking is an extremely important job. The national living wage, which was £5.93 an hour in 2010, is now £7.50 an hour, and lower-paid workers pay £1,200 less in income tax than they did in 2010. We are well on the path to rewarding careworkers far more than they have been in the past, although we would acknowledge that there is more to do.

--- Later in debate ---

[Barbara Keeley]

If the Minister values care, would he comment on untrained members of the public being offered £1,000 a month to rent out rooms as an alternative to care for patients recovering from surgery? Do he and his Government support that, because it is frightening from a safeguarding point of view?

[Mr Jones]

It is important that we always have workers who are trained, and we are providing care in good-quality settings. We heard several times that 80% of our care homes are providing quality of care that is either good or outstanding.

My hon. Friend the Member for Totnes mentioned the integration of health and social care, and the importance of the health service in the context of the review that is going to be done. She spoke about future planning of the workforce, which is also very important.

The hon. Member for Leicester West (Liz Kendall) made some very sensible points and comments about the politics of dealing with long-term funding of social care, and said that it does not serve people or their carers if we are partisan. Even so, she slipped into a bit of partisanship towards the end, showing how difficult this situation is. On the whole, however, she made some very sensible points.

My hon. Friend the Member for Erewash (Maggie Throup) was right to point out that this is a long-standing issue that many Governments over decades have ducked. She mentioned the situation in Derbyshire with her council, which seems to have been left a difficult legacy by its Labour predecessor. I am certainly willing to meet her to discuss that issue.

My hon. Friend the Member for Halesowen and Rowley Regis (James Morris) mentioned the positive impact that the £2 billion of additional funding that was announced in the Budget for the adult social care precept has had in his area. He also made a sensible point about the potential for devolution to bring more integration between health and social care. My hon. Friend the Member for St Ives (Derek Thomas) said that health and social care is not just a responsibility for national Government because there is a responsibility on us all, particularly at a local level within the health service and in our local authorities.

My hon. Friend the Member for South West Bedfordshire (Andrew Selous) raised the importance of suitable accommodation to enable older people to live independently and help us to avoid many of the healthcare costs that we face. My hon. Friend the Member for Yeovil (Mr Fysh) mentioned the pressure that the national living wage puts on the system. It is quite right that we pay our careworkers more, and that is why we have given councils access to up to £9.25 billion of extra funding by 2020.

Many positive speeches were made during the debate, but unfortunately I have not got time to mention them all. The problems in social care have developed over many decades. The Government are absolutely right to recognise the challenges of adult social care and tackle them head-on. That is why we have provided further funding up to 2020. We need to address the issue, and that is why we will work across the sector to bring about change and a sustainable solution for the future so that the most vulnerable in our society can get the care that they deserve and need.

Question put and agreed to.

Resolved,

That this House notes the Conservative Party’s manifesto commitment to a funding proposal for social care which would have no cap on care costs and would include the value of homes in the means test for care at home; further notes that this proposal would leave people with a maximum of only £100,000 of assets; calls on the Government to confirm its intention not to proceed with this commitment; and further calls on the Government to remove the threat to withdraw social care funding from, and stop fines on, local authorities for Delayed Transfers of Care and to commit to the extra funding needed to close the social care funding gap for 2017 and the remaining years of the 2017 Parliament.

[Barbara Keeley]

On a point of order, Madam Deputy Speaker. Again we see the Government refusing to vote on a motion—[Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I cannot hear what the hon. Lady at the Dispatch Box is saying, and she is speaking to me.

[Barbara Keeley]

Thank you, Madam Deputy Speaker. Again, we see the Government abstaining—refusing to vote on a motion tabled by the Opposition. This time, we have been debating vital issues: the funding crisis in social care and whether the Government will confirm their intention not to proceed with the policy for funding social care that they put forward, frightening people, during the general election.

My hon. Friend the Member for Denton and Reddish (Andrew Gwynne) has just described this Government as the “weakest and most divided” for many years. May I ask you, Madam Deputy Speaker, whether it is in order for this weak and divided Government to pick and choose when they will vote on matters that are raised in this House?

[Madam Deputy Speaker]

The hon. Lady has taken this opportunity to make the points that she wishes to make, and the House has heard them. She knows, and the House knows, that the Government’s decision on what they answer, what Ministers say at the Dispatch Box and how individual Members of this House choose to vote—or not—are not matters for the Chair. We will have no more points of order on that; it is not a point of order.