Adult Social Care

David Anderson Excerpts

Monday 16th July 2012 Commons Chamber

[Paul Burstow]

No, I am talking about the time at which in the sequence of my speech I will make the point about the Dilnot commission recommendations.

I wish to make one other observation on the national care service White Paper that the Labour Government published seven days before the last general election was called. Our White Paper addresses the end-of-life care issues, but Labour’s failed to address them.

[Mr David Anderson (Blaydon) (Lab)]

The Minister is rightly critical of the failure of the previous Government to bring in care for the people of England. Does he support what was done in Scotland by the previous Government?

--- Later in debate ---

[Mr David Anderson (Blaydon) (Lab)]

In 1989 I became a care worker after losing my job as a coal miner. I did so almost by mistake, but it was one of the best decisions I ever made, and over the next 16 years, as a care worker and as a representative of people working in care, I came to realise that we can look at care in three ways: we can provide none, provide it on the cheap or provide quality. We cannot do a combination of the three, and I hope that in the Chamber tonight we all agree that, if we are going to do quality care, we need to look after the work force properly, train them properly, treat them like professionals, have them in numbers, respect them, treat them with dignity, have the resources in place and give them some responsibility. They respond to that if allowed to, and the best way they respond is by showing respect for, and treating with dignity, the people they are taking care of, building the trust and confidence not just of those they are caring for but of their carers—their family and their friends who look after them.

I believe that my Government did some good things over their 13 years in office, regardless of what the Minister says, but in truth we did not do enough. In 1999 we set up the Sutherland commission, but we backed down on it—we chickened out. We did the right thing in Scotland, and, yes, it was done under coalition government, but the commission was set up by a Labour Government.

We should have done more, and we have a chance today to do more. My view is clear: why is someone needing care because they cannot take care of themselves different from someone who needs care because they are ill? We never say to anyone who needs physical or mental care on the NHS that they cannot have it, but we do say that to people who cannot take themselves to the toilet, bath themselves or take their medication. We would never do that with children, so why should we do it with the elderly and disabled?

I am clear that there is a cost; of course there is. I want to ask the Minister about some of the things he was saying earlier, and I hope that I get a response. What resources are we going to put in? If there are to be 100,000 apprentices, what will that cost? If there is to be a new code of conduct, what is the implication of that? If there is to be extra training, what will that cost? All those things are welcome, but if we are just going to talk about them and not resource them, we might as well not bother to talk about them.

I would like to have clear in my mind the issue raised by my right hon. Friend the Member for Oldham West and Royton (Mr Meacher). What is the difference between what is now proposed and the death tax that the current Secretary of State so cleverly used during the last election to undermine the stuff that my Government were trying to do? He talked then about £8,000 a year and a saving of £40,000 for everyone. That has all disappeared—it is all under the carpet. Did he mean what he was saying back then and does he mean what he is saying now?

Yes, if we are going to do this properly, there will be a cost—but we always find the cost of going to war and of extending the nuclear deterrent. In the past week, we have found the cost of taking 3,500 troops off duty to save the embarrassment of the Home Secretary. If we can do all that for those reasons, why can we not do it to take care of the elderly, vulnerable and frail in this country?

We were attacked by the Minister, who said that Labour MPs were moaning and whining on. That is part of the game that we play in this place, but what about what other people are saying? The Care and Support Alliance says that

“the social care system faces collapse”,

while the Alzheimer’s Society says:

“Millions of vulnerable people had been promised vital reform but today they are being massively let down.”

Mencap says:

“this promising blue print will never get off the ground if it fails to address the chronic underfunding in social care.”

Finally, the UK Home Care Association says:

“The Coalition Government’s White Paper has failed the frail and disabled”.

Those are those organisations’ words—not mine, and not my party’s.

Like other Opposition Members, I believe that the only real answer is a care system funded from general taxation. We have a generational chance to make this a crusade, just as 60 years ago people in this House made a crusade for the NHS. I know that some Government Members will say that that has been anathema, because ultimately the NHS—when we get down to the bare bones—is socialism in action. It is socialism delivering for the people of this country. What I want would be exactly that—the strong providing for the weak, not the weak being let down by the strong. We have the chance to do that. It is a challenge for this generation. The question for all of us on both sides of the House is: are we up for it?

--- Later in debate ---

[Margot James]

I am grateful to the hon. Lady for clarifying that. According to local government statistics, in the six years up to 2010, the spend was flat, and I have mentioned the demographic pressures. Interestingly, the same analysis states that over the same time, NHS expenditure rose by 27%, expenditure on the police rose by 20%, and even expenditure on schools rose by 12%.

A picture is emerging of the deprioritising of adult social care under the last Government. That is the origin of the problem that we are debating. That is what gave rise to the restrictions of the eligibility criteria for care. Long before this Government came to office, many local authorities started to restrict eligibility to those in moderate need of care and then to those in critical need of care.

[Mr Anderson]

Will the hon. Lady give way?

[Margot James]

I will give way one more time.

[Mr Anderson]

I appreciate it.

May I suggest that in criticising the last Government, the hon. Lady needs also to look at the record of the Government before that? Throughout the 1980s and 1990s, the social care and health service budgets were drastically reduced to a degree that was an embarrassment to this country.

[Margot James]

I welcome the hon. Gentleman’s intervention, but I will move on to the present day, relevant though the NHS and social care budgets of 20 or 30 years ago no doubt are.

We are beset by problems, although I was pleased to hear the Minister confirm that according to ADASS, social care spending has gone down by just 1% in the past year. Given the incredibly difficult economic situation that we are in, much of which we inherited from the previous Government, that is an achievement. However, we do have problems.

People value their independence, and most older people want to stay in their own home. With the right support, many can. To a large extent, the White Paper proposals will provide the support that is needed to enable more people to stay at home. Carers are a vital source of people’s ability to maintain their independence at home, and the 5 million carers who do an incredibly important job in our country do not get enough support at the moment. I welcome the extra money that is being put towards enabling them to have respite, because carers tell me that a break is what they need first and foremost. I am sure that no amount of money would ever be enough to give them the breaks and support that they need, but at least the White Paper proposals will provide some support.

Many people do not realise that social care is means-tested until they get to the point in their lives at which they need it. That means that we need more information to be available. We need to be honest with people about what is possible, what is available and what is not. All Governments are guilty of putting the best picture forward, which is sometimes misleading. I applaud the Government’s decision to commit £32.5 million to improving information, but perhaps I can make a plea on behalf of some of my older constituents: that investment should not all be online. Many older people do not communicate in that way, so we must allow for some leaflets in GPs’ surgeries, libraries and day centres, and for other traditional forms of communication. Otherwise, we will make older people who do not engage with new media even more dependent on other people to get information for them.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

I was heartened by some of what I read in the motion tabled by the Opposition. Welcoming the measures laid out in the care and support White Paper was a good start to a process that will be immensely easier with genuine co-operation and communication. However, the speeches from the Opposition Front Bench were partisan and contained no acknowledgement that for 13 years they did nothing. The hon. Member for Leicester West (Liz Kendall) seems to have amnesia. Cheap party political squabbling is not attractive. I remind the hon. Member for Hackney North and Stoke Newington (Ms Abbott) that she was very political by trying not to be political. I remind her also that 40,000 people a year had to sell their homes to pay for their care. It reflects badly on her and on the House and does nothing to improve the lives of service users, carers and staff. A White Paper seven days before the general election announcement counts for little.

Care has to be funded in a way that is fair on service users and fair on the taxpayer. We agree with Dilnot that financial protection through capped costs and an extended means test are the right basis for any new funding system. Given the extra public spending that will be involved, we need to consider that alongside other priorities. An issue that has been raised throughout the debate is the funding for the means-tested system. The right place—the responsible place—to consider that is in the course of the spending review and I do not intend to pre-empt that tonight. I draw hon. Members’ attention to the progress report. Many of the answers to the questions that they raise are included in that. The hon. Member for Hackney North and Stoke Newington would do well to refer to figure 4 in the report.

We have allocated an extra £7.2 billion to improve care and support as part of the spending review. That comes as part of what we know is a tough settlement for local government. If spent well, it will go far and will help local authorities maintain people’s access to care and support. The recent report from Demos and Scope shows that this can be done, and that reduced funding does not have to mean a reduced service. By putting more into reablement services that help people regain their independence, for example, or by supporting people to live in the community instead of in expensive residential care, local authorities can provide the best standards of care while saving money.

My hon. Friend the Minister of State mentioned the £32.5 million for better online services and traditional communication methods to help people see what services are available, whether their care is paid for by them or by the state. Likewise, there is an additional £200 million for specialised housing. That additional money more than pays for the White Paper proposals leading up to the comprehensive spending review. As my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) said, the issue was ducked repeatedly by the previous Government in far more favourable economic times. He also drew attention to the absurd distinctions between health and social care and the need for integration.

My hon. Friend the Member for Congleton (Fiona Bruce) spoke from the heart about the needs of carers, the £400 million we have provided for carers’ breaks and the end of permanent billing. My hon. Friend the Member for Southport (John Pugh) spoke of the contribution older people make and how to stop the fit becoming frail. My hon. Friend the Member for Stourbridge (Margot James) reiterated the ADASS figures and the desire for people to stay in their own homes. My hon. Friend the Member for Truro and Falmouth (Sarah Newton) spoke with passion and knowledge of the unity and commonality of purpose we need and the divisive nature of the Opposition’s motion. My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) pointed out the huge need to address the needs of people with disabilities.

These are ambitious plans. As well as setting out a comprehensive package of reform for the longer term, the White Paper announces changes that will make a difference immediately: a national eligibility threshold; proper and meaningful portability; duties to share information to ensure that people can move without losing their care; a focus on housing; provider quality profiles so that people can finally have clear information on the quality of care providers; mandatory adult safeguarding boards; and a requirement to assess carers’ needs and actually meet them—much neglected help and support. It also announces a code of conduct and minimum training standards for care workers so that people know that their care is underpinned by high standards of training and ethics. We will train more care workers, with 50,000 more apprenticeships by 2017, double the current number.

[Mr Anderson]

rose—

[Anne Milton]

The hon. Gentleman should welcome that.

The White Paper opens for business the new national information website so that people can find out more about all parts of the care and support system. It sets out legal entitlements to personal budgets so that care users, their families and their carers can choose what services they get. There are improvements to the transition from children’s services to adult services. These are big changes, egalitarian changes and, most of all, they will be effective changes. We are also reforming the existing social care legislation through the draft Care and Support Bill. The White Paper is about keeping people well and helping them to take control, get independent and live the lives they deserve with the certainty and security they need to do so with dignity.

There are times when we, as politicians, need not only to open our eyes and ears to the world outside this House, but to stand in the shoes of those we represent. They do not want to see us argue, squabble and bicker over their lives. On this issue, perhaps more than any other, we need to work together. If we do that, we can improve the system for millions of people, whether they use the services or care for someone who uses them. The system is funded until the next spending review.

I urge Opposition Members and Front Benchers to put aside party political differences and work alongside us to ensure that we have a system that is sustainable not only for this year and next, until the next general election, but for the years ahead. Older people in this country, the carers who support them and people with disabilities deserve that. The White Paper gives us a foundation on which to work, a foundation that has been missing for far too long. In 13 years in government, in favourable economic times, those now on the Opposition Benches did nothing that was sustainable in the long term. We need a foundation that gives us a chance to build a care and support system that future generations will be proud of. I urge the House to reject the motion.

Question put,