Care: Budget

Baroness Jolly Excerpts

Wednesday 28th January 2015 Lords Chamber

[Lord Clinton-Davis]

To ask Her Majesty’s Government whether they intend to cut the care budget and, if so, by how much.

[Baroness Jolly (LD)]

My Lords, social care budgets are set by each individual local authority. This allows councils to work with their residents to decide how best to make their spending decisions, based on local priorities and needs. In 2015-16, the better care fund will provide £5.4 billion of investment into better integrated care, from 1 April 2015, based on joint plans that have been developed locally.

[Lord Clinton-Davis (Lab)]

Does not the policy which the Government have declared in the past hit, in particular, the old and the vulnerable? Is it not a fact that £1 billion is being removed from the care budget, revealing that the Government are determined at all costs, whatever the price paid by poorer people, to reduce the role of the state and to punish those who cannot hit back? Why instead do the Government not deal with the bankers in the same way? Are they not primarily responsible for the position we are now in?

[Baroness Jolly]

My Lords, I can speak for local authorities but not, regrettably, for bankers. The Government have made care a priority, which is why we have given an extra £1.1 billion to help protect social care services this year, on top of the additional funding in recent years.

[Baroness Pitkeathley (Lab)]

My Lords, whatever the size of the care budget, I think everybody would agree that the majority of caring responsibilities fall on the caring families. Over the course of the next Parliament, some 10.5 million people will start being carers. Is the Minister confident that the budget will be sufficient to provide them with the information and support they so desperately need?

[Baroness Jolly]

A lot of work has gone on in preparing local authorities to give assessments to carers for their needs and support, in exactly the same way as they assess the people they care for. The cost currently being factored in for that is £104.6 million—£31.3 million on assessments and £73.3 million on the provision of support.

[Baroness Greengross (CB)]

My Lords, a couple of days ago, Age UK published its scorecard, which shows that, despite rising numbers of older people and rising demand for services, the amount spent has fallen dramatically over the past few years. In fact, it has gone down by over 40%. There are some shocking figures, for example that half of the people who struggle to get into a bath or to wash do not get any help, and that one in three of those who cannot go to the toilet without help are not getting any help, and preventive services are going down. In the light of that, does the noble Baroness not think that, nationally, it is time for the Government to come in with some direction?

[Baroness Jolly]

The Government have been trying very hard to give direction. One issue that we have been trying to direct is integrated care, joining up care services. However, public finances are in a precarious position. The deficit is still projected to be over £100 billion. The report from Age UK is a very good and interesting read, but I discussed it with officials this morning and we could not follow some of the figures and ways of working from its results.

[Baroness Barker (LD)]

My Lords, will the Government extend the better care fund into future years in order to transfer resources from the NHS to social care, so that the number of people having to go into hospital can be reduced?

[Baroness Jolly]

Certainly, that is the Government’s aim, and we legislated to establish the better care fund, providing £5.4 billion from this year through to next year. Quite what happens thereafter will depend on the result of the election in May.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is the noble Baroness seriously saying that the Government are not responsible for the funding cuts to local government and the consequent impact of a reduction in social care services? On the better care fund that she referred to for the next financial year, I refer her back to the King’s Fund quarterly monitoring report, which we discussed yesterday, which showed that 83% of NHS trust finance directors were not confident that the fund will be able to reduce pressure on A&E services. The better care fund is destined to fail.

[Baroness Jolly]

I think the noble Lord will expect me to disagree with him on that issue. A lot of work has gone in with local authorities, with the CCGs and with NHS trusts to try to ensure that that work succeeds.

[Baroness Howarth of Breckland (CB)]

My Lords, the noble Baroness will know that local authorities and health services that have already combined their services are still struggling. Indeed, on the radio today they said that they are doing their best but they cannot give the kind of service they want. I give only that example, but the noble Baroness will know of many others. Yesterday I asked her—and I ask again—how she can hold local government services to account on quality when they are all saying that, without proper funding, quality will fail. Can the noble Baroness answer that question today?

[Baroness Jolly]

I am sorry that I failed to respond to the question yesterday. Quality, of course, is monitored by the CQC. Certainly, it looks at all local authority and other care providers and, indeed, the NHS. As I said earlier, the Government make decisions about how much funding to put into community local government, the whole pot then goes down to local authorities and it is local decision-makers who decide how much money goes into which budget.

[Lord Lexden (Con)]

In this week that marks the 50th anniversary of Churchill’s death and state funeral, would we not do well to reflect for a moment on a few simple, eloquent words of his on this subject? In 1951, he wrote:

“The care and comfort of the elderly is a sacred trust”.

Must we not do all that we can in our time to meet that great man’s standard?

[Baroness Jolly]

I think that is highly laudable. However, the situation that we find ourselves in is that over the past five years we have had over 1 million more over-65s, and unfortunately that adds hugely to the care bill. So, I regret that we may not be able to meet some of Winston Churchill’s demands.

[The Countess of Mar (CB)]

My Lords, at the beginning of last month, I led a debate on the lack of a governance framework for social and health care. Has the noble Baroness taken time to think about what I said? She offered me a meeting but that has not transpired.

--- Later in debate ---

[Baroness Jolly]

I am sorry that my noble friend Lord Howe is not here because he and I discussed that issue together when he returned from his trip, and it was on his list of things to do, so I will contact his office about it. As regards governance, where local authorities and NHS trusts work together, one of the first things that they put down, if you like, is how the governance should operate between the two organisations.

[Baroness Farrington of Ribbleton (Lab)]

One of the complaints that the Minister must have heard is that her Government—who apparently are not responsible for bankers—are micromanaging what happens at local level, because they determine not only the size of the grant but spending targets. There is a terrible mismatch between those areas of the country which need to spend more than other areas and the targets and grant that those authorities are given. I cite my own city of Preston, and Lancashire, which are losing money and are areas of deprivation. Does the Minister agree that it is no good the Government saying that it is up to local authorities when they are controlling everything from the centre and that they should not wash their hands of it in public?

[Baroness Jolly]

My Lords, for as long we have had money distributed among local authorities and the NHS, there have been debates about the fairness of how it has happened. I live in a poor rural area and certainly we say much the same sort of thing.