Department of Health and Social Care and Ministry of Housing, Communities and Local Government

Caroline Dinenage Excerpts

Monday 2nd July 2018 Commons Chamber

[The Minister for Care (Caroline Dinenage)]

I would like to start by welcoming the recent joint report from the Health and Social Care Committee and the Housing, Communities and Local Government Committee on long-term social care funding. I am extremely grateful for their incredibly collaborative approach to working on this report, which captures a number of important voices on the subject of social care funding, not least the citizens assembly. The Government will of course respond to the report fully in due course. I agree that it is time to set political differences aside in addressing these issues, and we welcome the involvement of parliamentarians from across the House, as well as that of leaders, professionals and experts from the health and care sector, in doing so.

This has been a wide-ranging report, which has mainly been constructive and collaborative. In the time left to me, I will try to cover as many points as I can, but if I do not get to some of them, I will write to the Members concerned. The Government recognise that demands on our health and social care systems continue to grow, as people live longer than ever before, often with multiple complex conditions. For that reason, we have increased the funding available to the NHS in real terms every year since 2010 and given councils access to up to £9.4 billion more dedicated funding for social care over three years.

My hon. Friend the Member for Totnes (Dr Wollaston) spoke about integration and how Torbay is a great shining beacon of integrated care. The Government also recognise that the health and social care systems are intimately linked, and we have set out our intention to pursue a major drive towards better integration in order to achieve person- centred, co-ordinated care. We are committed to increasing the NHS budget to ensure that patients can get the care they need in a financially sustainable system. Our NHS now has in real terms about £14 billion more to spend on caring for patients than it did in 2010-11. With our NHS funding at record levels, that means more patients are being treated, and more operations are being carried out than ever before, by more doctors and nurses; this represents more than 14,500 more doctors and almost 13,300 more nurses on our wards. But we recognise, as so many Members from across the House have said, that NHS and social care provision are two sides of the same coin.

The long-term funding report mentions the current state of the social care system, and it is important to be clear about what the Government have already done to support local authorities in England. We understand the pressures on the system, which is why at the spring Budget in 2017 we gave councils access to £2 billion more funding. We are committed to creating a sustainable system of social care in England, which is why, as a starting point, the Government gave councils access to £9.4 billion more dedicated funding for social care over three years.

So many Members have set out the importance of early intervention to manage the demand for crucial health services and improve people’s wellbeing. The 2015 spending review made available £16 billion of funding for local authorities in England for public health. That was in addition to the money that the NHS spends on prevention, including our world-leading screening and immunisation programmes and the world’s first national diabetes prevention programme. Our investment is making a real difference, including to social care services throughout the country, with a 39.6% reduction in delayed transfers of care attributable to adult social care between February 2017 and April 2018.

We are taking additional steps to ensure that those areas that face the greatest challenges improve services at the interface between social care and the NHS. That includes the establishment of a series of local system reviews led by the Care Quality Commission, to evaluate the boundary between health and social care’s functionality. It is absolutely right that future social care funding is agreed alongside the rest of the local government settlement at the forthcoming spending review. The settlement will of course apply to older and working-age adults as well.

We recognise that an ageing society means that we need to reach a longer-term sustainable settlement for social care. An ageing society puts pressure on local authority budgets, on providers and on local services, which is why the Government have committed to publishing a Green Paper to outline our proposals for change. We recognise that decisions on future reforms of the NHS and social care must be aligned, which is precisely why we will publish the Green Paper at the same time as the NHS plan, to ensure that the system is sustainable going forward.

As the hon. Member for Sheffield South East (Mr Betts) so eloquently said, a priority for reform is making sure that people are better able to plan ahead and protect themselves against the highest care costs. It is not fair that some people in our society currently stand to lose the majority of the savings and wealth that they have built up over a lifetime. The Select Committees’ report highlights that issue powerfully.

Many Members spoke about the drive towards the integration of health and care services. The better care fund is our programme for joined-up health and care services, which will allow people to manage their own health and wellbeing and live independently in their communities for as long as possible. In 2015-16, some 90% of local area leaders said that the better care fund had already had a positive impact on integration locally. Nobody underestimates the pressures that local authorities and health providers are under, but working collaboratively, communicating better and avoiding duplication of effort is a good way to use resources.

In advance of the NHS’s 70th anniversary later this week, the Prime Minister announced her intention for the Government to work with the NHS to develop a 10-year plan for the future of the health service. That is underpinned by a five-year funding offer, which will see the NHS budget grow in real terms by more than £20 billion a year by 2023-24. That funding growth is significantly faster than for the economy as a whole and reinforces this Government’s commitment to the NHS as our top spending priority. Such intervention is possible only because of the difficult decisions that the Government took to get our nation’s finances back in order.

My hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) spoke about how we must be really honest about where the funding is coming from. My right hon. Friend the Prime Minister said that we will listen to views about how we will do that, and my right hon. Friend the Chancellor will set out the detail in due course.

In return for the new investment, the Government will now ask NHS leaders to produce a new 10-year plan, led by clinicians and supported by local health and care systems throughout the country. The plan will set a vision for the health service, ensuring that every penny is well spent and focused on improving outcomes for patients. We welcome parliamentarians’ continued contributions to informing the debate across health and social care. I commend the estimates to the House.