Reform of Social Care
Charlie Elphicke Excerpts(13 years, 4 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
As my hon. Friend will know, local authorities were keen for many of the grants that we provided not to be ring-fenced in future, including the social care, public health and learning disability grants. We aim to give local government more flexibility, but, through the NHS, we are providing additional resources—in Bromley and elsewhere—to support preventive interventions that benefit both social care and the NHS, and I think that that will make a big difference in Bromley. As we know, however, all local authorities are, of necessity, having to seek greater efficiencies, and we are working with local government to identify where they can be delivered. There is still a dramatic variation between the costs of care services provided in different parts of the country.
Charlie Elphicke (Dover) (Con)
As we know, going into a home is long on cost but short on life expectancy. I particularly welcomed my right hon. Friend’s comments about greater prevention. What more can be done to promote access to—and promote in general—day care and respite care?
Mr Lansley
We have made specific additional provision to support respite care. I hope that people will be given more independence and support at home not only as a result of NHS support—the £648 million that will be provided this year is a great deal of money, which will substantially increase access to such facilities as community equipment, home adaptations, reablement and rehabilitation —but through, for instance, telehealth, which I mentioned in response to an earlier question. I think that we can transform the quality of care and health services provided at home.
NHS Future Forum
Charlie Elphicke Excerpts(13 years, 5 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
The latest figures on the changes in staffing in the NHS since the general election have shown a reduction of 3,800 managers, an increase of 2,500 in the number of doctors and no reduction in the number of nurses.
Charlie Elphicke (Dover) (Con)
In Dover and Deal, we have dynamic GPs, many of whom want to get involved in commissioning, but not every GP wants to do so. Will the Secretary of State confirm that no individual GP will be forced to be involved in the work of the commissioning group and that that was always the case under his reforms?
Mr Lansley
My hon. Friend makes a good point. Many GPs across the country understand that clinically led commissioning is the right thing to do, but they do not personally want to be involved in that process. There are, however, leaders who do, and leaders across the country have already come forward through pathfinder consortia and will be a basis on which we can create much greater clinical leadership across the service. The Future Forum was very clear that leadership from within the service, from doctors, nurses and other health professionals, will be instrumental in improving care in the future.
Future of the NHS
Charlie Elphicke Excerpts(13 years, 6 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
John Healey
Indeed, they are comprehensive, consistent and coherent, and they are wrong.
Charlie Elphicke (Dover) (Con)
I thank the right hon. Gentleman for being so generous in taking interventions. He has told the House that the plans are wrong. However, in January 2010, he said to the King’s Fund:
“The general aims of reform are sound”.
It seems to me that he has changed his mind.
Mr Lansley
The support for cancer networks will continue during the course of this year and the start of next year, but when the NHS commissioning board takes responsibility for commissioning, including the relationship with consortia, it will need to decide how to manage its commissioning responsibilities. However, as I have told my hon. Friend in the House previously, it is now looking—we will look at this over the coming months—at how it can use networks as a basis for having precisely the kind of commissioning structures we want, and it is my expectation that that would include cancer networks that are not only helpful for providers, but that tie together commissioners and providers in understanding the future strategy for cancer.
Mr Lansley
If my hon. Friend will forgive me, I will give way again a little later, but first I want to make a couple of further points.
The House knows of my commitment to the NHS; Opposition Members know of that, too. They know that I have not spent seven and a half years as shadow Secretary and Secretary of State to see the NHS undermined, fragmented or privatised. They know that that was never my intention; it is not my intention. Before the last election, we were absolutely clear that we would protect the NHS, but we are doing more than just protecting it; we are strengthening it. We are enabling clinicians to lead a more integrated, responsive, accountable NHS—not fragmented, not privatised, not based on access to insurance, and not compromising quality for price—and, equally, an NHS that is not run by a top-down, unaccountable bureaucracy, but that is locally led and locally accountable.
As the right hon. Member for Wentworth and Dearne admitted, this is a comprehensive, consistent and coherent vision, and it is an evolution of the better policies of the last 20 years. It was the last Labour Government who introduced patient choice; we will extend it and give patients the information they need to make it work. It was the last Labour Government who introduced practice-based commissioning; we will make it real, with health professionals designing integrated pathways of care with decision-making responsibilities. It was the last Labour Government who introduced foundation trusts; we will deliver on their broken promise to take all NHS trusts to foundation status. It was the last Labour Government who introduced payment by results, but left it half baked, distorting services and hindering joined-up care; we will change it so that it genuinely supports the best care for patients. Of course, it was the last Labour Government who brought the independent sector and competition into the NHS, but we will not follow their lead by giving the independent and private sector providers the opportunity to cherry-pick services and by giving them financial advantages over NHS providers.
Care for the Elderly (Kent)
Charlie Elphicke Excerpts(13 years, 9 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Charlie Elphicke (Dover) (Con)
Thank you, Mrs Brooke. I am deeply obliged to you for giving me an extra two minutes for this debate. I am delighted and proud to have secured a debate on this important issue, which matters to all residents in Kent. I shall focus on my constituents and those of my hon. Friend the Member for Dartford (Gareth Johnson).
This matter is extremely dear to the hearts of my constituents. Securing a safe, loving home is of the utmost importance for any family member hoping to make the final years of their relation, normally their parents, nice and happy. It is not always easy, and once people find a good home, they want their family member to settle there for a long time, and not have the disruption of moving from one home to another.
That was the experience I had with my father, who was in residential care for some 10 years. For the last 10 years of his life, he suffered from Alzheimer’s. He barely recognised me and could not communicate very effectively. I had to look after him and ensure that his needs were met. That experience coincided with the period between 1997 and 2002, when regulations were changed and care homes were closing all around Kent. I had to move him from home to home, trying to ensure that he had the love, care, support and, in particular, stability that older people need in residential care.
Hon. Members will recall that we lost some 2,000 care homes during that period. My father’s experience, which was by no means unique, left me with a passion for ensuring that we look after older people who should have dignity in their final years, and the stability and care that they deserve.
Glyn Davies (Montgomeryshire) (Con)
I thank my hon. Friend for allowing me to comment. I am clearly not from Kent, but I have a huge interest in the issue that he raises. Does he agree that providing a service for the elderly, particularly those who suffer from neurological illness, is one of the greatest challenges for the current Government over the next few years, and that over the past two decades the British Parliament simply has not met that challenge?
Charlie Elphicke
I strongly agree. The population is ageing, and we know that the need for care of the elderly will increase, not lessen, over time. With the triumph of longevity comes the downside that people may well require more care—respite and day care but also residential care—for longer, and that will have a cost. There will be an expense to society, but society can rise to the challenge by ensuring that services are of the standard that we would expect. My hon. Friend’s comment is particularly relevant, given the announcement that Sampson Court, the much loved care home in my town of Deal, is to be closed by Kent county council.
Sampson Court provides a range of services—palliative care, day care and respite care—and specialises in dementia and separate elderly mentally infirm care. It is extremely important to the community and loved not only by residents but by their families, all of whom have been passionate in their support for keeping that important community facility open. Despite that, Sampson Court is no longer classed as meeting care standards—hon. Members will recall that the previous Government introduced the decent homes standard—and because it does not have en-suite bathrooms and the building is costly to maintain and in need of renovation, Kent county council says that it is too expensive to make those changes and that it cannot continue to run the home.
That decision was a challenge to the community, which started a consultation. The community has worked hard and, led by Councillor Julie Rook in Deal, has made a passionate case for not closing the home—a petition with 5,000 signatures was delivered to the council—and for finding an alternative way forward. A transfer of going concern has been raised as a possibility.
The parents of my constituent, Mr Hawker, receive care at Sampson Court. He wrote to me:
“Sampson Court is in no way beyond the end of its life at 25 years old…it’s well maintained, clean and hygienic, and en-suite facilities would be actually hazardous to those who cannot even use a toilet without assistance such as my father who has dementia and is incontinent.”
Kent county council has cited European Union procurement rules as a reason for not doing a transfer of going concern. It says that it is extraordinarily costly to do such a transfer under those rules, and that, because of the complexity, the only realistic possibility is simply to close the home and sell the site, despite the potential interest of other care home operators who might like to take it on.
My constituent Gareth Fowler, whose mother has been at Sampson Court for four years, asked the council representative at a public meeting during the consultation process where the 15 EMI residents would go. The council had no answer other than “the local area”. Mr Fowler rang every EMI care home in the local area, but none had any space. If a decision is taken to close a home, there must be an alternative. There is great concern among my constituents that there is no alternative place for them to go to.
My constituents point to the Kent county council consultation, which states:
“People rightly expect more choice in their care”.
There is no doubt that its decision has left less choice, not more. I would ask the Minister to review whether Kent county council has an effective alternative plan for elderly people. Mr Fowler’s experience suggests that it does not. Sampson Court is a much-loved community resource that is fully workable. That begs the question, why can it not be retained, if not by Kent county council then by another body, to ensure that we have proper care for the elderly in Kent?
As well as criticising Kent county council, I want to be positive about it. I understand the challenge to its budget, the challenge in meeting the decent homes standard, and the challenge of the EU public procurement regime, which is expensive and, frankly, gold-plated—it ought to be minimised. Can anything be done about public procurement in this kind of case?
The other case I have been making to Kent county council is that it could transfer the home, not as a going concern in the market but to a community interest company. That is where my interest particularly lies. Allowing a community outside the regime of Government, the procurement rules and all the regulations to take it on would enable the expertise of local care home operators to be captured so that a home could continue to operate on that site in the future. I am asking for Government support and guidance on how Sampson Court might be transferred to a CIC in partnership with local care home operators.
Hon. Members will no doubt know that a CIC could provide the benefit and excellence of a care home in a local community. It would have flexibility and access to a range of financing options, and would be a solution to the decision that Kent county council has made. It would mean that local people can come together and work to secure a community takeover that would bring the community together, provide better value for money and ensure more freedom to offer extended services. We could turn a community resource that is fast disappearing into one that is expanding.
We should not lose community resources such as Sampson Court, but this debate is not just about Sampson Court or care for the elderly in Kent. I bring the matter to the Minister’s attention because I suspect that this is a wider issue across counties and the country as a whole, and that there are many similar cases involving aged buildings, the decent homes standard and EU public procurement rules. Many communities are in the same boat, so the national picture needs to be examined to ensure that there is effective transition—and enough care for the elderly across the whole of Kent.
Local GP, John Sharvill, wrote to me. He said that, without a doubt, Sampson Court
“is an excellent institution providing fantastic care...there is no other home in this area which provides the level of care that they do in the spacious, airy, surroundings they provide”.
Using the community right to challenge and the community right to buy under the Localism Bill, soon to become an Act, may provide a way forward. There is a right for voluntary and community groups, social enterprises, parish councils and local authority employees to challenge a local authority on delivery of a service by expressing an interest in running a service for which they are responsible. The local authority must consider and respond to such a challenge, which may trigger a procurement exercise for the service, in line with relevant procedure, in which the challenging organisation could bid, alongside others. Such rights are part of the Government’s aim to create a big society. The Minister of State, Department for Communities and Local Government, my right hon. Friend the Member for Tunbridge Wells (Greg Clark), is sitting next to me. He has an interest in the Localism Bill, which is currently before the House.
When listed assets—either the freehold or a long leasehold—come up for disposal, communities will be given the chance to develop a bid and raise the capital to buy the asset when it comes on the open market. However, there are issues with that, which I would like to flag up. First, the local authority does not have to seek out possible community owners, and there is no compulsion for it to do so. That means that communities may struggle if they are up against the local authority, especially as there is no independent monitor to judge a community bid against a local authority’s plans. Secondly, if a local authority wishes to proceed with a sell-off, there is no provision for a temporary stop, a break for consideration, or a certain designated time that would allow community groups time to put together and advance a bid.
John Porter of the “Bowles Lodge Stays!” campaign, run elsewhere in Kent, also flagged up those kind of problems. He pointed out the difficulties he had over the care of his mother, Vera Woylor, who is an 89-year-old resident of the care home and does not want to move. On her behalf, he has made a strong case to Kent county council, which does not think that the right process has been followed. The ideal would be to enable continuity of care. Such issues need to be addressed, and community interest companies should be encouraged.
Ministers may consider the matter to be simply a local issue, but given the terms of the Localism Bill it is a wider national issue of how we can encourage takeovers by community interest companies and what we can do to simplify EU public procurement regulations to ensure that homes, such as Sampson Court and others across Kent, give continuity of care and love under new ownership if they cannot remain under that of Kent county council.
Health and Social Care Bill
Charlie Elphicke Excerpts(13 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
I have given way to the right hon. Gentleman before.
General practitioners and health care professionals in GP pathfinders are, in contrast to the unions, enthusiastic about what we are trying to achieve. For example, Dr Paul Zollinger-Read, a general practitioner and the chief executive of NHS Cambridgeshire, said recently:
“In our area, the GPs got together and focused on quality of care. They looked at diabetic care, for example, and services in this area improved. That means fewer diabetics will need to go to hospital in an emergency, there will be fewer amputations and less heart and kidney disease.”
Far from GPs being reluctant at the thought of taking on new responsibilities, applications to be pathfinder consortia were over-subscribed.
Oral Answers to Questions
Charlie Elphicke Excerpts(13 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
Since we have no plan either to dismantle or to privatise the NHS, it is no surprise that people were not told of any such plan. Before the election and in the Conservative manifesto, people were told of our determination to cut bureaucracy and get money to front-line care. They were told of the determination of both parties in the coalition to get decision making close to the front line, to enhance accountability, including democratic accountability, and to give greater responsibility to clinicians to lead the development of services.
Charlie Elphicke (Dover) (Con)
2. What steps he plans to take to increase cancer survival rates.
Graham Evans (Weaver Vale) (Con)
10. What assessment he has made of the effects on survival rates of his Department’s cancer strategy.
The Minister of State, Department of Health (Paul Burstow)
We published “Improving Outcomes: A Strategy for Cancer” on 12 January, which sets out a range of actions to improve cancer outcomes, including diagnosing cancer earlier, helping people to live healthier lives to reduce preventable cancers, screening more people, introducing new screening programmes, and ensuring that all patients have access to the best possible treatment, care and support. Through those approaches, we aim to save at least an additional 5,000 lives every year by 2014-15.
Charlie Elphicke
May I raise the case of my constituent, Suzanne Lloyd, who was diagnosed with breast cancer a decade ago? She was told that she had two years to live, but has successfully battled cancer for the last decade. The problem is that she has also been battling health chiefs to give her the drugs that she needs to extend her life. Will the Minister tell the House about measures to increase longevity through greater drug access?
Paul Burstow
Just last year the national clinical director published a report on the extent and causes of international variations in drug usage, which revealed that the UK tends to lag behind other countries in its use of newer cancer drugs. That is one reason why we have introduced the interim cancer drugs fund of £50 million in this current year and will introduce the full fund of £200 million from this April. That will help my hon. Friend’s constituent.
Public Health White Paper
Charlie Elphicke Excerpts(13 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Lansley
No; the response to infectious diseases will continue to be the responsibility of the Department of Health, with a more integrated Public Health England incorporating the responsibilities of the Health Protection Agency and recommendations from the Joint Committee on Vaccination and Immunisation and others. There was a lot of important debate about the discontinuation of the BCG inoculation. My view is that targeted action in areas with high prevalence of TB—as there is in a small number of places—is more appropriate than the introduction of any generalised inoculation at this stage.
Charlie Elphicke (Dover) (Con)
But when and how will action be taken on the evil of cheap supermarket booze?
Mr Lansley
My hon. Friend will not have to wait long for announcements from hon. Friends of mine in the Government.